Application for the FMI MD-PhD Program

Complete this form in English; fields marked * must be completed. Unmarked fields can be completed on a voluntary basis if you feel it is relevant to your application.

Information submitted will only be distributed internally for evaluation purpose.


Personal Details:

Last name:
 *
First name:
 *
Birthday:
 * (yyyy/mm/dd)
Birthplace:
Nationality:
 *
Gender:
Street:
 *
Street 2:
Postal code, city:
 *
Country:
 *
Phone:
 *
Email:
 *  
Confirm email:
 *

HOW DID YOU HEAR ABOUT THE FMI MD-PhD PROGRAM? *
 *
If "Other" please explain: (max. 50 characters)
   

Education:

Universities/Colleges attended:
* Complete at least one row.
Dates:
Start
End
(expected)
Degree:
Upload copy of diplomas at the end of this form.
Grade:
(convert from local system)
1(low) - 10(high) or N/A
 *  
 
 
 
 *
 *  
 
 
 
 *  
 
 
 

Honours, scholarships, prizes
List any awards relevant to this application, giving dates and a brief description.

Research Experience:

Important *: Please give the title and a short description of any research project carried out during your studies (diploma thesis, honours project, MSc thesis, etc.). State the rationale and goals of the research, and indicate your own contributions to the results (ca. 300 words).
 

Scientific Interests:

Important *: Please describe your general research interests (ca. 200 words).
 

Describe a paper you have read:

Important *: Elaborate on a recent scientific article that you found particularly interesting (ca. 200 words).
 

Specific Interests in Research at FMI:

Important *: Please have a look at the research areas and projects described on the FMI website, and elaborate on what you find interesting about those areas (200-300 words).
 *
 *
 

Keywords:

Important *: Please consider carefully the keywords listed below and select up to 5 keywords closest to your interests.










 

Reference Letters:

Please provide the name and email address of three (minimum: one) referees who are familiar with your research training and education.

As we will contact referees automatically when you have submitted your application, we recommend that you inform them ahead of time. Reference letters should be provided on a template that can be downloaded here, but will also be included in the email sent to each of your referees.
Last name:
First name:
Email:
Confirm email:
   *
 
 

Comments:

Please include here any additional information you feel is relevant to your application (additional nationality, other diplomas, hobbies, interests not related to your studies).
 

Attachments:

Important *: Only PDF files are accepted. Both files combined should not exceed 7MB.
CV:
 *    
Univ. degrees:
 *